周围型非小细胞肺癌体部伽马刀和调强适形放疗的剂量学比较研究  

Dosimetric Study of Intensity Modulated Radiation Therapy and Body Gamma-Knife Radiosurgery for Peripheral Non-small-cell Lung Cancer

作　　者：刘利民[1] 苏加利[1] 李强[1] 黄高明 LIU Li-min;SU Jia-li;LI Qiang;et al(Department of Radiation Oncology, the 163 Hospital of PLA, Hunan changsha 410003, China)

机构地区：[1]湖南师范大学第二附属医院及暨解放军第一六三医院肿瘤科,湖南长沙410003

出　　处：《医学临床研究》2018年第6期1041-1043,1046,共4页Journal of Clinical Research

基　　金：湖南省教育厅资助项目（课题号：17C0966）

摘　　要：【目的】比较体部伽马刀和调强适形放射治疗（IMRT）技术对周围型非小细胞肺癌（NSCLC）实施放疗计划的剂量学特点。【方法】对11例NSCLC同时应用体部伽马刀和IMRT制定放射治疗计划，总剂量为66Gy。计划标准为处方剂量至少覆盖95％的计划靶体积（PTV），各危及器官剂量均要求在耐受剂量范围内。通过靶区的等剂量分布、剂量体积直方图（DVH）以及适形指数（CI）和均匀指数（HI）等比较肿瘤靶区剂量和正常组织受照射剂量的差异。【结果】IMRT计划的CI和HI均优于伽马刀计划；伽马刀计划周围正常组织的剂量全肺的V5、V10、V20、V30均显著低于IMRT计划（P〈o．05）。伽马刀PTV最大剂量（Dmax）、平均剂量（Dmean）、最小剂量（Dmin）优于相应的IMRT指标，靶区剂量比IMRT计划要高（P〈0．05）。【结论】伽马刀治疗周围型的NSCLC可显著提高靶区剂量，同时很好地保护周围正常组织，在综合治疗中更有提高治疗增益比潜能。[Objective]To investigate the dosimetric characteristic of radiotherapy for peripheral non-small-cell lung cancer （NSCLC） with body y-knife （MASEP body 7-knife） and intensity modulated radiation therapy （IMRT）.[Meth- ods]A total of 11 patients with peripheral non-small-cell lung cancer were selected in the study. Two treatment plans were designed for each patient, including γ-knife and IMRT. The total prescribed dose was 66 Gy for each patient. The plan- ning standard was that the prescribed dose covered at least 95 % of the planned target volume （PTV）, and each dangerous organ dose was required to be within the tolerable dose range. The difference between the tumor target dose and the nor- mal tissue exposure dose was compared by the isodose distribution of the target area, dose volume histogram （DVH）, conformity index （CI）, and heterogeneity index （HI）.[Results]CI and HI of the IMRT plan were superior to the γ-knife plan. The V5, V10, V20, and V30 doses of surrounding normal tissues of the ）＇-knife plan were significantly lower than those of the IMRT plan （ P〈0.05）. The maximal dose （Dmax）, mean dose （Dmean）, and minimum dose （Dmin） of gamma-knife PTV were better than the corresponding IMRT indicators, and the target dose was higher than the IMRT plan （ P〈0.05）.[Conclusion]Body γ-knife treatment of peripheral non-small-cell lung cancer can significantly increase the target volume close as well as protect the surrounding normal tissue. It has the potential to improve efficacy of compre- hensive treatment.

关 键 词：癌 非小细胞肺/外科学 放射外科手术 放射疗法 调强适形 

分 类 号：R734.2[医药卫生—肿瘤]